Why is network design so important? It is the blueprint for the network, the roadmap for the implementation, and the way to ensure that you will have a network that matches your members needs.

In a nutshell, network design is the critically important process of developing and implementing a model for a network of healthcare providers to deliver coordinated care to patients while improving the quality of care, efficiency in the delivery of care, and managing the overall affordability of care.

While there are many areas that fall under ‘Network Design’, the main factors to consider when designing a clinical network are:

• The needs of the patient population
• The capabilities of the providers
• The available resources
• The regulatory environment

The Zula Health specialty network design process typically involves the following steps:

• Identify the needs of the patient population: what specialty health options do they require, do they need, and do they want? Remember, a robust specialty network of providers can offer. What are the most common health conditions in the population? What are the patient’s needs for care?
• Evaluate the available provider population: how many are available to be recruited? Are they willing to join a network? What challenges do providers face in participating in the network?
• Identify the size and scope of the network: are there network adequacy issues or specific geographic challenges?
• Assess the care provided by the network: services offered and scope of practice considerations.
• Analyze the reimbursement policies for the providers: should they be paid by case rate, per diem, or by specific CPT code?
• Consider the regulatory environment. What regulations apply to the network? How will the network comply with these regulations?

From this, Zula Health develops a custom plan for payers that takes into account:

• The goals of the payer
• The services that will be offered
• The way that the network will be managed
• A detailed plan for the recruitment, contracting, and credentialing of providers to participate on the network
• A process to evaluate the impact of the network through the analysis of data on the quality, efficiency, and affordability of care, which will be used to make improvements to the network.

Clinical network design is a complex process, but it can be a valuable tool for improving the quality, efficiency, and affordability of healthcare.

Here are some of the benefits of working with Zula Health for your  network design:

• Improved quality of care for your members
• Increased efficiency in the delivery of care
• Reduced cost in the provision of care
• Better data analysis
• Increased member satisfaction and engagement
• Provider satisfaction